HISTORY OF SURGERY: FIRST WORLD WAR

HISTOIRE DE LA CHIRURGIE: PREMIRE GUERRE MONDIALE

Somewhere in France (9 April 17): a centenary

review of medical arrangements at Vimy Ridge

Vivian McAlister, MB Summary

In April 1917, medical units of the 4 divisions of the Canadian Corps combined
Accepted Mar. 6, 2017 for the first time in support of a single action, the assault upon Vimy Ridge.
Detailed planning, infrastructure development, information dissemination and
Correspondence to: rehearsal were features of preparations by the combat arms and medical ele-
V. McAlister ments of the Canadian Forces. Extraordinary coordination resulted in the rapid
C8-005, University Hospital rescue and evacuation by Canadian medical services of 8000 casualties over
London ON N6A 5A5 4 days. Characteristics of todays military medical services are evident in the
vmcalist@uwo.ca work of the Canadian Army Medical Corps 100 years ago.

DOI: 10.1503/cjs.003417

S
uccessful Canadian actions at Vimy Ridge and Hill 70 book-ended the
Battle of Arras, a major component of the 1917 Nivelle Offensive of the
First World War. Their impact was greater in Canada than Europe,
with the Battle of Vimy Ridge, in particular, being considered a nationally
defining moment. Although some historians consider the claims of today to be
exaggerated, the achievements of the Canadian Corps were recognized for the
remarkable feats that they were at the time. Had the Nivelle Offensive been suc-
cessful in its goal to break the German line, these Canadian actions would be
remembered as the turning point in the war. The equally remarkable success of
the Canadian Army Medical Corps in these battles is the subject of this essay.
Frances Tenth Army had failed to dislodge the Germans from Vimy Ridge
on several occasions in 1915, suffering 150 000 casualties, many of whom
remained in no mans land. The British XVII Corps relieved the French in
February 1916. The Canadian Corps arrived in the sector in October 1916.
The 3 divisions of the Canadian Corps had been joined by the 4th Canadian
Division in August 1916 at the Battle of the Somme. The Canadians had since
become adept at raiding German lines, mostly at night, to harass the enemy
and capture intelligence. In March 1917, the 4th Division launched the most
ambitious raid yet. Combining stealth and gas, they sought to prove their
worth to their veteran colleagues by attacking German trenches on Vimy
Ridge. The result was disastrous. The casualty rate was 43%, or 687 men. Sur-
vivors remembered it as a proper slaughter.1 Combined with the withering
losses suffered at the Somme, it put the Canadian Corps at risk of collapse. In
March 1917, the Canadian Corps received orders to take and hold Vimy Ridge.
The hallmarks of the Corps strategy were meticulous planning, information
dissemination, infrastructure development (e.g., communication trenches and
attack tunnels), rehearsal and flexibility, all new to the war. Sir Julian Byng,
Corps commander, and Arthur Currie, commander of the 2nd Division, are
credited with the innovations. No longer would men be left without objectives
because their captain had been hit: they could outflank machine guns so long as
they did not lose contact with their unit; attacks were coordinated to follow
creeping artillery barrages in order to deny the enemy time to reset their
machine guns. Uniquely these strategies were rehearsed by units in models of
their sector. Medical arrangements for the battle used similar strategies to cor-
rect errors of the past. Crucially combat troops were ordered not to stop for
injured comrades and were assured of aid by special teams during the battle.

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HISTOIRE DE LA CHIRURGIE: PREMIRE GUERRE MONDIALE
Twelve of Canadas 16 field ambulance units were
deployed in the Battle of Vimy Ridge. Field ambulances
were the favoured destination for medical students from
Canadian universities who volunteered for service, inter-
rupting their studies. Famous examples include Frederick
Banting, Norman Bethune and Harold Griffith (pioneer
anesthesiologist).2,3 Even though each unit was attached to
1 of the 4 Canadian divisions, they pooled resources to
form a central trunk supporting each unit as a branch.
Most of the field ambulances were tasked with clearing
the field and maintaining an advance dressing station.4
Upon receiving instructions, each unit surveyed its sector
and prepared structures including the advance dressing
station, field ambulance relay posts, accommodation for
stretcher bearers and regimental aid posts.4 Roads leading
to Vimy had 3 lines of traffic to accommodate the buildup
to the battle, and still medical units had difficulties receiv-
ing materials and supplies. For divisions 13, stretcher
cases were taken to a Corps dressing station at Les Quatre
Vents while the walking wounded went to Villers-au-Bois.
The 4th Division was separated from the rest of the Corps
by topography and took stretcher and walking casualties
Fig. 1. Canadian medics, aided by German prisoners, move 4 casualties on an improvised stretcher car along tram lines during the
Battle of Vimy Ridge, April 1917. (Library and Archives Canada: MIKAN 3194779).
84 o
J can chir, Vol. 60, N 2, avril 2017
to la Haie and Hersin-Coupigny, respectively. Efficient
and effective evacuation was the priority of the medical
services close to the front. The No. 1 Canadian Casualty
Clearing Station, the first point where surgery could be
performed, was placed at Aubigny, and a motor ambu-
lance convoy was stationed at Bruay. Tramlines were con-
structed to move casualties along lines of evacuation that
would otherwise have become impassable owing to mud
(Fig. 1). Improvised stretcher cars were moved by men or
mules. The tramlines converged at Ambulance Point,
from where the Army controlled evacuation of casualties
out of the area of operations.
At 5:30 am on Easter Monday, Apr. 9, 1917, pipers with
the Princess Patricias Canadian Light Infantry Regiment
of the 3rd Canadian Division struck up their bagpipes as
their men, with the rest of the Canadian Corps, entered no
mans land, chasing the artillery barrage up the Vimy hill-
side. It is doubtful if the Germans or even the Canadians
heard the pipes, such was noise of bombardment. The
pipers were there because their main role was as stretcher
bearers and they followed the first line of men out into the
field of battle. Fighting was fierce. Lance Sergeant Ellis

Sifton from the tiny town of Tyrconnell, Ont., made it
into a German machine gun dugout. He first kicked over
the machine gun and then attacked its crew with his bay
onet before being killed. He was posthumously awarded
the Victoria Cross 1 of 4 awarded to Canadians for their
efforts that day.
By dark, it was clear that the assault had been successful
even though fighting continued for 4 days. Remarkably the
field was cleared of casualties by midnight. The rapidity with
which the injured were rescued taxed the lines of evacuation
considerably. Rain and then snow worsened the situation.
MacPhail4 blames the back-up on delays removing treated
casualties out of the area of operations an Army rather
than a Medical Corps responsibility. This may be reason-
able, as all transport was requisitioned temporarily to resup-
ply the combat units. Telephone communication remained
open to the front lines throughout the battle. Frantic calls
eventually resulted in 2 additional roads being opened fol-
lowed by rapid clearance of casualties. By 2 am on Apr. 10,
5976 patients were safe in casualty clearing stations, warmly
housed at Les Quatre Vents, or evacuated.4 In the 4 days of
fighting Canadian medical services looked after
4265stretcher cases and 3791 walking wounded, including
706 enemy casualties. Fit German prisoners assisted the
medical crews, with only casual guarding apparent.
Field ambulances today are responsible for North Atlan-
tic Treaty Organization (NATO) Role 1 care, treatment at
the point of injury and evacuation.5 The organization, pri-
orities and actions of the Royal Canadian Medical Service
today can trace their origins to Vimy, where for the first
time brigade and divisional medical resources were pooled
in a great scheme of coordination. Rapid rescue from the
point of injury, with effective primary care, remains the pri-
ority of the service. Senior medical officers today will sym-
pathize with their Vimy ancestors when lines of supply or
evacuation are threatened by the priority they receive from
HISTORY OF SURGERY: FIRST WORLD WAR
centralized transport. Cooperation between echelons of
care, today defined by NATO but based on those used in
the First World War, remains the basis for achieving the
goal of ameliorating the injuries of war.5
The feat achieved by the Canadian medical services par-
allel that by combat arms at the Battle of Vimy Ridge. From
todays perspective, both are unfathomable. Victory at Vimy
was celebrated in Canada and recognized by the authorities.
Arthur Curry was knighted in the field by the King and
given command of the Canadian Corps, itself a recognition
of Canadian self-sufficiency. Curry would revise higher
commands mission to take the town of Lens into a success-
ful repeat of Vimy Ridge at Hill 70, where he drew German
forces into a terrible slaughter. Byng was given command of
Britains Third Army and was elevated to the peerage as
Baron (later Viscount) Byng of Vimy. He served as Canadas
twelfth Governor General. An impromptu memorial at
Vimy was replaced in 1936 by Canadas iconic monument to
the bravery, sacrifice and savagery of war.
Affiliations: From the Department of Surgery, Western University,
London, Ont.
Competing interests: None declared.
References
1. Cook T. A Proper Slaughter: the March 1917 gas raid at Vimy Ridge.
Can Mil Hist 1999;8:7-23.
2. Samuels PB. Two heroes of the class of onety-seven: Part I. Can J Surg
1990;33:69-74.
3. Samuels PB. Two heroes of the class of onety-seven: Part III. Can J
Surg 1990;33:147-51.
4. MacPhail A. Official history of the Canadian Forces in the Great
War 19141919: The Medical Services. Ottawa (ON): Department
of National Defence; 1925. pp. 91-9.
5. Brisebois R, Hennecke P, Kao R, et al. The Role 3 Multinational
Medical Unit at Kandahar Airfield 2005-2010. Can J Surg 2011;
54:S124-9.
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